Personalizing the World Health Crisis

Fourteen million people die each year from treatable diseases like HIV/AIDS, malaria, tuberculosis, and diarrhea, while another two billion are infected. In addition to these main killers are the numerous little known diseases like sleeping sickness, river blindness, rotavirus, and trachoma, all of which shatter families, jolt economies and destabilize security and food supplies. More than one billion people lack access to clean water, and 2.6 billion lack access to sanitation. Yet the amount spent on world health is less than two percent of the global military budget. World health is a human right and the most pressing development issue facing us today.

By living among, and forming intimate friendships with the diseased and disenfranchised people whose stories are documented, this project aims to give a voice, hope and dignity to the victims, and humanize the crisis by putting faces and personalities on the overwhelming statistics.

The first leg of this project documented disease and dislocation among the disenfranchised San of the Kalahari in Botswana. The Bushmen are the poorest of the poor in Botswana, which has one of the highest rates of HIV/AIDS in the world, with up to forty percent of adults infected. Dislocation and dispossession are major co-factors in the spread of AIDS, and many other diseases. People without homes get sicker than people with homes. And when people get sick they want to go home. Recently the court in Botswana ordered the government to allow Bushmen to return to their homes in the Central Kalahari Game Reserve, from where they have been forcibly removed, for many years, to what the Botswana government calls resettlements and that some Bushmen call "places of death." During the fall of 2005, I lived with Nanke, a single mother with AIDS, and her family who suffer TB, malaria, and alcoholism. He photographed everyday life.

There are an estimated 38 million blind people in the world - of those, 28 million are unnecessarily blind. The second leg of the project documented trachoma. Spread by flies, it is the world's leading cause of preventable blindness. Trachoma is pandemic in Ethiopia, where big strides are being made to eradicate this ancient disease of poverty and poor sanitation. As trachoma progresses, often for 15 years or more, the eyelids turn inward, scratching the eyeball causing unbearable itching, infection, and scarring that inevitably leads to blindness if not treated, early (with what amounts to a dollar's worth of antibiotics) or later with surgery.

The next leg of the project is about malaria. Malaria is pandemic in many places, especially in sub-Saharan Africa, but this story takes place where the fear originates: along the Thai/Burmese border, in Karen refugee camps, where the world's most resistant parasites and fatal strains of malaria thrive. No one knows why, even though the hospital and numerous malaria clinics in the Mae Sot district treat hundreds of thousands of patients every year, and researchers come from all over the world to study the problem. Malaria is the constant companion of everyone who lives here. Dr. Cynthia Maung has dedicated her clinic to the cause for over thirty years. But the war involves educating people, who change slowly, and may not even associate malaria with mosquitoes, and parasites that change too quickly for drugs to keep up. Mobile blood clinics make early falciparum diagnoses so that treatment can be rushed to the infected migrant population.

This project will illustrate the cultural politics and anthropology of malaria: how people experience it; how malaria shatters families, stunts and destabilizes economies, security and food supplies; how malariologists, technologists, educators, and a vast culture of malaria survivors fight what the WHO calls the "public health enemy number one."

Malaria cases, drug resistance, and mosquito persistence are worsening around the world. With the globe becoming more traveled and warmer, deforestation, expanding mosquito habitat, and indiscriminate anti-malarial use, the fear is that the world's most untreatable malaria will find its way to Africa and the temperate zones. Nevertheless, there are hopes for its eradication and this project will document the realities, dilemmas and consequences surrounding eradication programs, including DDT.

The story moves to Tanzania where the entire population is exposed to malaria for a least part of the year, and, where malaria is the country's biggest killer. Here communities are benefiting from new drugs and eradication strategies, including favoring the manufacture and distribution of insecticide impregnated bed nets, over indoor spraying of DDT. A dire shortage of the promising anti-malarial plant Sweet Wormwood has prompted a number of agencies to transplant the herb, which the WHO predicts will cut the world's malaria deaths in half, from China to Tanzania.

After malaria the project will focus on diabetes among Canada's First Nations people, tuberculosis in Russian prisons, obesity in America, river blindness, schistosomiasis or snail fever, lymphatic filariasis, and other diseases.

Cover story: Robert Semeniuk's World Health project featured in the Seattle Times weekend magazine, "Terrible Truths: Photographer Robert Semeniuk won't let us look away," by Seattle Times writer Paula Bock, August 12, 2007.

Exhibition - Trachoma in Ethiopia, photographs from Personalizing the World Health Crisis, from The Gallery on Bowen Island and The Bowen Island Arts Council.